Oak Valley Alf

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL11647 Issued in FL

Legal business name

OAK VALLEY ALF

Practice address

4488 Highway 79
Vernon, FL 32462-3778

Phone

(850) 535-4196

Fax

(850) 535-0271

NPI assigned

Mar 16, 2011

Last updated

Mar 16, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Monroe Frank Easterling II

Title

Owner

Phone

(850) 535-4196

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1235438250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 HIGHWAY 79",
            "city": "VERNON",
            "state": "FL",
            "postal_code": "324623778",
            "telephone_number": "850-535-4196",
            "fax_number": "850-535-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 HIGHWAY 79",
            "city": "VERNON",
            "state": "FL",
            "postal_code": "324623778",
            "telephone_number": "850-535-4196",
            "fax_number": "850-535-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK VALLEY ALF",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "EASTERLING",
        "authorized_official_first_name": "MONROE",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-535-4196",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "AL11647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001563700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• L&S Home Health Care
• Jessica Lynn Mahaffey
• Michael D Nissen, N.P.-C
• Northwest Florida Healthcare, Inc. (Vernon Clinic - Northwest Florida Community Hospital)
• Northwest Florida Healthcare, Inc. (Vernon Clinic-NFCH)
• Samuel E Ward MD PL (Ward Medical Clinic)
• Vernon Discount Drug Inc

• Assisted Living Facility (Mental Illness) in Vernon, FL
• Providers in Vernon, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.